Department of Health Management & Informatics, University of Central Florida, Orlando, Florida, USA.
Department of Internal Medicine, University of Central Florida, Orlando, Florida, USA.
Subst Abus. 2021;42(4):735-750. doi: 10.1080/08897077.2020.1846666. Epub 2020 Dec 7.
Criminal problem-solving and dependency courts set treatment standards for opioid use disorder (OUD) but sometimes prohibit or limit utilization of medications for OUD (MOUD). Court staff beliefs about MOUD inform court treatment policies. Court staff MOUD policies may also be influenced by social norms, meaning perceptions of opinions of other individuals/entities about MOUD, including opinions of fellow staff in their court, staff in other courts, the state supreme court, other state agencies, the National Association of Drug Court Professionals (NADCP), federal agencies, and local peer support groups. To date no study has examined social norms among court staff with respect to MOUD. We distributed an online cross-sectional survey in 2019 to all criminal problem-solving and dependency court staff in Florida. Respondents were asked to identify the extent to which they cared about different entities'/individuals' opinions about MOUD and the extent to which they perceived each of those entities/individuals as encouraging MOUD. We hypothesized that court role and court type would be associated with responses. We used descriptive statistics, logistic regressions, and difference of proportions tests to analyze data. 20% of the population ( = 119) completed the survey. Respondents cared most about the opinions of external treatment providers with whom they collaborate, fellow staff in their court, and the NADCP regarding MOUD. Fewer than half felt that any of these entities/individuals encourage methadone or oral buprenorphine. Additionally, fewer than 11% of respondents felt that local twelve-step peer support groups encourage the use of any form of MOUD. MOUD education should target all members of court teams, including collaborating treatment providers. Since court staff care relatively little about the MOUD opinions of staff in other courts, changes in opinions in one court may not affect changes in opinions in a neighboring court. The NADCP should more explicitly state its support for MOUD, and specifically oral buprenorphine and methadone treatment.
刑事问题解决和依赖法庭为阿片类药物使用障碍（OUD）设定了治疗标准，但有时会禁止或限制使用 OUD 的药物治疗（MOUD）。法庭工作人员对 MOUD 的看法会影响法庭的治疗政策。法庭工作人员的 MOUD 政策也可能受到社会规范的影响，这意味着他们对其他个人/实体对 MOUD 的看法，包括他们所在法庭的同事、其他法庭的工作人员、州最高法院、其他州机构、国家药物法庭专业人员协会（NADCP）、联邦机构和当地同行支持团体的看法。迄今为止，尚无研究探讨过法庭工作人员对 MOUD 的社会规范。我们在 2019 年向佛罗里达州所有刑事问题解决和依赖法庭的工作人员分发了一份在线横断面调查。要求受访者确定他们对不同实体/个人对 MOUD 的看法的重视程度，以及他们对每个实体/个人对 MOUD 的鼓励程度的看法。我们假设法庭角色和法庭类型与反应有关。我们使用描述性统计、逻辑回归和比例差异检验来分析数据。20%的人口（=119）完成了调查。受访者最关心与他们合作的外部治疗提供者、他们所在法庭的同事以及 NADCP 对 MOUD 的看法。不到一半的人认为这些实体/个人中的任何一个鼓励美沙酮或口服丁丙诺啡。此外，不到 11%的受访者认为当地的十二步同行支持小组鼓励使用任何形式的 MOUD。MOUD 教育应针对法庭团队的所有成员，包括合作治疗提供者。由于法庭工作人员对其他法庭工作人员对 MOUD 的看法相对不太关心，一个法庭的观点变化可能不会影响到邻近法庭的观点变化。NADCP 应更明确地表示其对 MOUD 的支持，特别是对口服丁丙诺啡和美沙酮治疗的支持。
